| NPI | 1407084031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY MARIE DAVENPORT President/Therapist 763-528-5235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 251S00000X Community/Behavioral Health | |
| 1041C0700X Social Worker, Clinical | |
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2018-05-18 |